Tailor-made ammonia nitrogen risk management with machine learning models for aquatic environments in the Mainland of China.

Efficient management of pollutant risks in water bodies is crucial for public health and aquatic ecosystem sustainability. However, the toxicities of pollutants, such as ammonia nitrogen (NH3-N), are often affected by multiple water quality factors, including the pH and water temperature. Extensive spatial and temporal variability in these factors hinders tailor-made management of risk. This study used high-frequency monitoring data collected over 1 year to evaluate the long-term NH3-N risk in China's aquatic ecosystems. High accuracy and interpretability were achieved by decomposing NH3-N risk into the contributions of key influencing factors using random forest models and Shapley Additive Explanations. Two distinct types of NH3-N risk hotspots were identified across 18 cities: 15 cities with high NH3-N concentrations and 3 cities with low environmental carrying capacity due to high pH levels or elevated water temperatures. For the former, rapid NH3-N abatement measures are necessary to bring NH3-N concentrations back below the environmental capacity. For the latter, it is recommended that NH3-N related industries are relocated to regions with high environmental capacities because fragile environments are not suitable for such industries. Importantly, this study investigated methods for attributing pollutant risks in the context of non-linear influencing factors, and the risk of NH3-N was predicted to increase by 6.1 % by the end of 2100 in the context of increasing temperatures under the SSP 2-4.5 scenario. The methodology is also adaptable and suitable for integration into global ecosystem risk management efforts to balance development and aquatic ecological sustainability.

Exploring the Knowledge and Use of Standardised Nursing Terminology Across Australia.

Standardised nursing terminologies (SNTs) support the visibility of nursing work and documentation, enabling data sharing and comparison. An online survey assessed the knowledge and use of SNTs and revealed barriers and enablers to their use by Australian nurses. Just over half of the respondents were familiar with SNTs before the survey, a quarter reported a reasonable understanding of SNTs, just under half reported previous use of a SNT, and less than 14% indicated a current use of a SNT in their workplace. Perceived benefits to SNTs identified by respondents included a reduction in variation and the ability to evaluate the effectiveness of nursing care by measuring outcomes. Both barriers and enablers to the use of SNTs included education and training, standardisation and contextualisation across Australia, and integration into any electronic medical record system. Nurses are poorly informed on what SNTs are and how they can be leveraged to support their work and documentation. There is a need for an Australia-wide strategic approach to ensure the future of nurses' work is visible, and SNTs are purposefully and correctly implemented across the country.

Implementing a National Nursing and Midwifery Digital Health Capability Framework: Exploring Knowledge, Experience in Informatics and Barriers and Enablers.

A National Nursing and Midwifery Digital Health Capability Framework was developed in 2020 to define and complement digital health knowledge and skills for professional practice. This mixed-methods study explored nurses' and midwives' Framework knowledge and its applicability, types and extent of nursing and midwifery informatics roles, and barriers and enablers to working in informatics. Survey respondents reported familiarity with the Framework, with content analysis identifying three themes - informatics as part of nursing or midwifery roles, descriptions and variability of informatics roles, and the need for informatics role development and recognition. Framework knowledge can be improved through standardised and defined roles and a career pathway that includes national, organisational, local, and individual support.

Characteristics of nursing educators' professional competency standards: A scoping review.

AIM: To map the characteristics of nursing educators' competency standards for practice from the existing literature, examine the evidence and identify commonalities and differences. BACKGROUND: Many countries or regions have produced nursing educator standards, however, there is no common set of standards or competencies used globally. Mapping these nursing educator standards should identify a common set of standards that can be applied across any nursing educator practice setting. DESIGN: The review was conducted using the JBI methodology for scoping reviews and followed an a priori protocol. METHODS: A comprehensive search of studies or guidelines (2001-2022) was undertaken to identify specific nursing educator competencies from any practice setting and in any language. Preceptorship and mentorship studies were excluded from the search terms. Databases searched for relevant records and guidelines were CINAHL, ERIC, Medline (Ovid), Pubmed, Scopus, Google and targeted websites. After screening and selection, relevant data were extracted and summarized using an extraction guide. Characteristics of the reports were identified and all three levels of competency statements were mapped against commonly occurring categories derived from the data. RESULTS: 1145 evidence records were screened after removal of duplicates with 14 records included in the review. The included evidence sources were from various nursing educator practice settings and educator roles. All evidence sources had at least two levels of competency statements and 16 competency categories were identified. Common categories in the first two competency levels were: leadership and management; research and scholarship; professional values and professional development; and facilitating learning. Statements related to learner evaluation were also common in the level 2 competencies. Level 3 competencies were included in seven evidence sources and most of the sources included almost all categories. Low-occurring statements at all levels were in the 'Nursing skills' and 'Decision-making/strategic planning" categories. CONCLUSIONS: Common characteristics and categories were found between different evidence sources in this review. The most common competency review categories included leadership and management, professional development and facilitating learning. Few decision-making competencies were identified from the evidence sources. These results can inform educators and managers in developing globally-based nursing educator competencies, performance management tools and job descriptions.

Development of a Canadian Guidance for Reporting Real-world Evidence for Regulatory and Health-Technology Assessment (HTA) Decision Making.

Real-world evidence (RWE) can complement and fill knowledge gaps from randomized controlled trials to assist in health-technology assessment (HTA) for regulatory decision-making. However, the generation of RWE is an intricate process with many sequential decision points, and different methods and approaches may impact the quality and reliability of evidence. Standardization and transparency in reporting these decisions is imperative to appraise RWE and incorporate it into HTA decision-making. A partnership between Canadian health system stakeholders, namely Health Canada and Canada's Drug Agency (formerly the Canadian Agency for Drugs and Technologies in Health (CADTH)), was established to develop a guidance for standardization of reporting of RWE for regulatory and HTA decision-making in Canada. In this article, we describe the methods to develop the Guidance for Reporting Real-World Evidence document and checklist for reporting RWE for regulatory and HTA decision-making in Canada. This guidance can be adapted for other jurisdictions and will have future extensions to incorporate emerging issues with RWE and HTA decision-making.

In vitro antimalarial susceptibility profile of Plasmodium falciparum isolates in the BEI Resources repository.

BEI Resources, a National Institute of Allergy and Infectious Diseases-funded program managed by the American Type Culture Collection, serves researchers worldwide through the provision of a centralized repository for the acquisition, production, characterization, preservation, storage, and distribution of standardized biological resources targeting National Institutes of Health priority pathogens including bacteria, viruses, pathogenic fungi, and parasitic protozoa. These reference materials are critical for the development of diagnostics, vaccines, and therapeutics and are available to qualified registered investigators and institutions worldwide. Bioresources within BEI include well-characterized malaria isolates as part of the Malaria Research and Reference Reagent Resource Center (MR4). These isolates are critical for screening antimalarial compounds, conducting drug resistance studies, and for resistance surveillance and management. In our efforts to enhance the characterization of MR4 P. falciparum isolates, we measured antimalarial susceptibility of >100 isolates against a panel of standard antimalarial compounds. Our results provide valuable information to assist current and prospective users of the BEI Resources repository in making data-driven requests of isolates to meet their research needs.

European Quality Markers in Oral and Maxillofacial Surgery Specialty Training: Defining Standards.

According to the European Union (EU) Directive 2005/36, the medical specialty of oral and maxillofacial surgery (OMFS) exists with two possible formats: dual degree OMFS called Dental, Oral and Maxillofacial Surgery (DOMFS) - basic medical and basic dental training and single medical degree Maxillofacial Surgery (MFS). Within the EU and across all of Europe, differences in the nature and quality of OMFS training coexist. By implementing the highest possible standards of training, patient care can be improved. To establish quality metrics for an ideal OMFS training programme, the European OMFS Trainee Forum of the Union Européenne des Médecins Spécialistes (UEMS) conducted a Delphi consensus protocol from November 2023 to January 2024. Facilitated by the OMFS Section of UEMS, 56 trainees from 32 countries participated. The process involved the definition of three quality levels using the red, amber, and green (RAG) rating system. Following the Delphi process, 46 domains were identified, including features within training programmes/rotations, teaching and education programmes, training placements, recording of training progression and activity, and external assessment of training programmes. The results were aligned with the UEMS OMFS European Training Requirement (ETR). With the introduction of a RAG rating, trainees and trainers can review their training programmes with the aim of improving them by moving domains from Red to Green. Raising the standard of training will benefit our patients. This initiative could mark a significant step towards the harmonisation of OMFS training, improving quality and ensuring consistent, high-level care throughout Europe.

Should a single growth standard be used to judge the nutritional status of children under age 5 years globally? No.

Universal growth standards for under-five children, given the worldwide variation in healthy growth and several determinants of anthropometry, are imprecise measures of nutritional status, particularly when used cross-sectionally. In constructing the global-use WHO growth standard, linear growth differences between contributing sites and pooled mean were >0.2 SD in 37% of observations. Systematic reviews confirm even greater variability, notably amplified for weight-for-age and head-circumference-for-age metrics. Unsurprisingly, developed nations had higher, and LMICs lower, growth dimensions. Contextual growth references predict neonatal morbidities, pathological short stature, macrocephaly, cardiometabolic risk factors, and adult noncommunicable diseases better than the WHO standards. Child body composition also varies contextually, with greater adiposity despite comparable weights in South Asian populations. Thus, contextual references, though not the perfect solution, are better suited for everyday practice and nutrition policy. Growth standards should only be used as a screening for clinical judgments aided by precise biomarkers.

Educational research on medical residency programs in Chile: a scoping review and analysis of the impact of the new accreditation policy.

BACKGROUND: Accrediting medical specialties programs are expected to influence and standardize training program quality, align curriculum with population needs, and improve learning environments. Despite global agreement on its necessity, methods vary widely. In the Chilean context, a recent new accreditation criteria includes research productivity in relation to educational research on resident programs, so we aimed to define it. What is the profile of publications in educational research produced by Chilean medical specialty residency programs in the last five years? Based on these results, we intend to analyze the potential impact of the new accreditation policy on medical specialty programs in Chile. METHODS: We performed a preliminary bibliometric search to identify the use of the term "resident" in literature. After that, we conducted a literature search, using a six-step approach to scoping reviews, including the appraisal of the methodological quality of the articles. RESULTS: Between 2019 and 2023, an average of 6.2 articles were published yearly (19%). The bibliometric analysis revealed that the dominant thematic area of the journals was clinical, accounting for 78.1%. Most articles focused on residents (84.38%), with only two articles including graduates as participants. One university was responsible for 62.50% of the articles and participated in all multicenter studies (9.38%). Surgical specialties produced 15 research articles focused on procedural training using simulation. Psychiatry was the second most productive specialty, with 5 articles (15.63%) covering standardized patients, well-being, and mental health assessment. The most frequent research focus within residency programs over the five-year period was teaching and learning methodologies, with 19 articles representing almost 60% of the total analyzed. CONCLUSIONS: Research on medical education in Chile's postgraduate residency programs is limited, with most studies concentrated in a few universities. The new accreditation criteria emphasize educational research, posing challenges for many institutions to meet higher standards. Understanding unexplored areas in educational research and learning from successful programs can enhance research productivity and align efforts with accreditation expectations. Continuous evaluation and new research on residents' satisfaction, skills acquisition, and well-being are needed to ensure training quality and accountability.

A U.S. Pharmacopeia (USP) overview of Pan American botanicals used in dietary supplements and herbal medicines.

The United States Pharmacopeial Convention (USP) is a nonprofit, scientific, standard-setting organization, and world leader in establishing quality, purity, and testing standards for medicines, foods, and dietary supplements. USP quality standards are used in more than 140 countries and are legally recognized by more than 40 countries. Currently, there is renewed interest in herbal medicines globally, and health policies are being implemented worldwide for the use of complementary and traditional medicine. In response, USP has developed a robust body of monographs that can be used to guide industry and regulators in ensuring the quality and safety of botanical ingredients used in dietary supplements and herbal medicines. Throughout the Pan American regions, there is a strong tradition of using botanicals as herbal medicines and, as in other regions, a growing desire for botanical dietary supplements. This underscores the need for public quality standards to ensure quality, reduce the flow of substandard and adulterated products, and ensure public health and safety. In April 2022, USP launched the Pan America Botanical Dietary Supplements and Herbal Medicines Expert Panel, with experts representing 12 different countries. The Expert Panel's work focuses on developing quality control standards for the most important botanical ingredients used in the respective countries, ingredients that are also of global importance. This article provides an overview of the state of botanical dietary supplements and herbal medicines in different Pan American regions with a focus on the regulatory status of herbal products, the development of national quality and research initiatives, and policies related to agriculture conservation and sustainability, among other topics.

Converting an HLA-B27 flow assay from the BD FACSCanto to the BD FACSLyric.

HLA-B27 is a major histocompatibility complex (MHC) class I antigen which exhibits strong association (90%) with ankylosing spondylitis. HLA-B27 detection in patients by flow cytometry is a widely used clinical test, performed on many different flow cytometer models. We sought to develop and validate a test conversion protocol for the HLA-B27 test performed on the BD FACSCanto to BD's newer FACSLyric flow cytometers. The development and validation experiments were performed using anti-HLA-B27*FITC/CD3*PE antibody-stained whole blood patient specimens. The anti-HLA-B27*FITC logarithmic median fluorescence (LMF) results on the BD FACSCanto were converted to median fluorescence intensity (MFI) values on the BD FACSLyric. Clustering of the HLA-B27 positive and negative values, using a 3rd order polynomial equation, resulted in a conversion of the BD FACSCanto cutoff values, negative (<150 LMF) and positive (≥160 LMF), to negative (<4530 MFI) and positive (≥6950 MFI) on the BD FACSLyric. Accuracy was assessed by comparing the flow results obtained on the BD FACSCanto and BD FACSLyric to a molecular PCR based assay. Additional validation parameters (compensation verification, intra- and inter-assay precision, and instrument comparison) were performed per the recommendations outlined in the Clinical and Laboratory Standards Institute (CLSI) H62 guidelines for validation of flow cytometry assays.

Deepfake: definitions, performance metrics and standards, datasets, and a meta-review.

Recent advancements in AI, especially deep learning, have contributed to a significant increase in the creation of new realistic-looking synthetic media (video, image, and audio) and manipulation of existing media, which has led to the creation of the new term "deepfake." Based on both the research literature and resources in English, this paper gives a comprehensive overview of deepfake, covering multiple important aspects of this emerging concept, including (1) different definitions, (2) commonly used performance metrics and standards, and (3) deepfake-related datasets. In addition, the paper also reports a meta-review of 15 selected deepfake-related survey papers published since 2020, focusing not only on the mentioned aspects but also on the analysis of key challenges and recommendations. We believe that this paper is the most comprehensive review of deepfake in terms of the aspects covered.

Vulnerable to heat stress: gaps in international standard metric thresholds.

Exposure time to heat is increasing with climate change. Heat exposure thresholds are important to inform heat early warning systems, and legislation and guidance for safety in the workplace. It has already been stated that thresholds can be lower for vulnerable groups, including the elderly, pregnant women, children, and those with pre-existing medical conditions due to their reduced ability to thermoregulate their temperature or apply cooling strategies. However, the Wet Bulb Globe Temperature (WBGT) proposed by the international standard organisation (ISO 7243:2017), only takes into account thresholds based on acclimatization status. Therefore in this study we carried out a PRISMA systematic keyword search of "Wet Bulb Globe Temperature" of the Scopus abstract and citation database in August 2023 and a meta-analysis of text extracted from the identified 913 international studies published between December 1957 and July 2023, to investigate heat stress thresholds for different population groups. We find that different thresholds are considered as an indication of heat stress for different population groups. However, critical gaps were identified for the most vulnerable populations, and there are lower numbers of studies on women. Most studies researched adult populations between the ages of 18 and 55 (n = 491), failing to include the youngest and oldest members of society. Based on these findings, we call for targeted investigations to inform effective heat action policies and set early warning thresholds to ensure the safety and wellbeing of the entire population.

Role of Food Safety Regulations in Protecting Public Health.

Food safety is a critical public health issue worldwide as the consumption of unhygienic food causes millions of illnesses annually. The contaminated food is primarily unsafe due to the presence of microorganisms (i.e. bacteria and viruses), chemicals (i.e. pesticides and heavy metals), and physical hazards (i.e. glass, metal and plastic). Foodborne illnesses such as salmonellosis, campylobacteriosis, listeriosis, E. coli infection, botulism, cholera, norovirus infection, and others are commonly caused by the problems associated with food hygiene. From the modest beginnings rooted in basic hygiene practices to the sophisticated frameworks of the modern era, the journey of food regulatory bodies has been marked by a commitment to protect consumers from the hazards associated with foodborne illnesses. In India, the 'Food Safety and Standards Authority of India sets standards, inspects food businesses, and acts against food safety violators. However, there is still more work to be done, including the effective enforcement of regulations, and thoroughly educating the consumers about food safety. The need of the hour is a multi-dimensional collaboration among different stakeholders to ensure that everyone has access to safe and nutritious food. In developing countries, the hurdles in preventing food adulteration include poor consumer awareness and insufficient resources for the enforcement of food regulations. Despite complications, the 'Food Safety and Standards Authority of India' is committed to improving food safety for consumers through cooperation with other agencies, increased enforcement, and public awareness initiatives. Developing countries face lots of challenges in regulating the safety of loose milk and street foods; including the problems of traceability, resource limitations, variety of techniques, cultural acceptance, and financial concerns. A multifaceted strategy that includes infrastructural development, consumer education, regulatory strengthening, and technological acceptance is needed to overcome all these problems linked to the safety of street foods and loose milk. Food regulators must set strict guidelines, conduct regular inspections, and licenses and training for various stakeholders involved. Proper education for customers should increase awareness and provide them with the latest information related to food safety. Access to clean water, sanitary facilities, waste management, and technological adoption should be the main priorities of infrastructure development. Challenges of traceability and labelling in loose milk and street foods include the threats of adulteration, inability to determine the origin, and improper labelling. Vendor registration, uniform labelling, stringent enforcement of food safety regulations, improved supply chain monitoring, consumer education, and technological adoption are all necessary to fully address these problems of food safety.

Standards for research in NHS Wales critical care units: A modified Delphi study.

Introduction: The importance of research and development in all aspects of healthcare is well acknowledged. Within critical care, national guidelines provide a limited number of standards and series of recommendations on Research and Development (R&D) activity. The aim of this study was to create a broader set of standards in support of R&D activity in critical care departments. Methods: A modified Delphi study was undertaken across NHS Wales critical care units. Proposed standards were developed by a group of experts, which across three rounds, majority agreement was sought. Additional standards were added based on participant's responses. Results: This study identified 49 standards for R&D activity within critical care units in NHS Wales. All these standards reached majority agreement, as determined by >70% of multi-disciplinary participants determine each standard as essential. Conclusions: The results of this study will be utilised within Wales to inform wider service specification with regard workforce requirements, responsibilities, reporting and collaboration.

Professionals' Readiness to Manage Violence Against Women.

Over recent years, community-based responses to domestic violence against women have become an important topic, and there is growing recognition that domestic violence requires a comprehensive response from agencies across a variety of community sectors. When reaching out for help, female survivors of domestic violence need to have access to a broad range of services, empowering professionals to manage violence against women, and coordinated community responses that promotes safety, autonomy, and integration. Since the early 1990s, Portugal has been gradually moving toward a community-based approach to domestic violence against women where local organizations and professionals are major stakeholders of this policy. Besides having had an increased network of services implemented, it is important to examine how prepared service providers are to respond effectively. The current study analyzed how ready professionals in Portugal are to deliver interventions targeting violence against women. A total of 585 professionals from different backgrounds completed a readiness survey. The results revealed that, despite their perceived readiness, professionals are not duly prepared to respond effectively to violence against women. They lack the appropriate knowledge and training to respond effectively to survivors. Hence, further efforts must be made to change professional practices and services to ensure that abuse is recognized, barriers are overcome, and interventions are more effective.

Establishing age- and sex-specific anthropometric growth references standards for South Punjab adolescents utilizing the LMS method: findings from the Pakistani population.

Background: The physical health of adolescents is crucial for the prosperity and sustainable development of a nation. Developing specific growth standards is essential for prioritizing the wellbeing of the youth of Pakistan. This study aimed to establish normative standards for height, weight, and body mass index (BMI) among 12- to 16-year-olds in South Punjab, facilitating accurate health assessments and tailored interventions. Method: This study utilized a cross-sectional design and stratified random sampling to select 2,970 adolescents (49.73% boys and 50.26% girls) aged 12-16 years from South Punjab, Pakistan. Anthropometric measurements, including height, weight, and BMI, were collected. The data were stratified by age and sex, and smoothed percentile curves were computed using the LMS method, which incorporates the L (γ-lambda), M (µ-mu), and S (δ-sigma) parameters. The results were compared to international references to provide a comprehensive analysis. Results: The results highlight sex-specific trends in anthropometric indicators among adolescents. Boys exhibited higher mean values in height (160.50 ± 11.50 cm), weight (45.02 ± 9.78 kg), and BMI (17.30 ± 2.41) than girls (158.57 ± 9.34 cm, 41.00 ± 7.89 kg, and 16.29 ± 2.82, respectively). Growth patterns indicate boys grow faster in height and weight between ages 12 and 14, whereas girls show slower annual increases. Comparative analysis with international standards reveals that boys' height and weight were generally lower than international medians (P50th), whereas girls' height was comparable or higher. BMI values for both sexes were lower than international norms, reflecting unique regional growth patterns. Conclusion: This research establishes updated age- and sex-specific normative reference standards for adolescents in South Punjab, Pakistan. The study revealed that Pakistani adolescent boys exhibit higher mean values in height, weight, and BMI than girls, with faster growth rates between ages 12 and 14. Compared to international standards, Pakistani adolescents show lower BMI values, highlighting unique regional growth patterns. These standards have practical applications in screening, monitoring, and health strategy planning, contributing to efforts to promote a healthier future for the population. Future studies are recommended to utilize these local growth references for health surveillance and treatment in the local population.

Stroke of Consistency: Streamlining Multicenter Protocols for Enhanced Reproducibility of Infarct Volumes in Preclinical Stroke Research.

BACKGROUND: The discrepancy between experimental research and clinical trial outcomes is a persistent challenge in preclinical studies, particularly in stroke research. A possible factor contributing to this issue is the lack of standardization across experimental stroke models, leading to poor reproducibility in multicenter studies. This study addresses this gap by aiming to enhance reproducibility and the efficacy of multicenter studies through the harmonization of protocols and training of involved personnel. METHODS: We established a set of standard operating procedures for various stroke models and the Neuroscore. These standard operating procedures were implemented across multiple research centers, followed by specialized, in-person training for all participants. We measured the variability in infarct volume both before and after the implementation of these standardized protocols and training sessions. RESULTS: The standardization process led to a significant reduction in variability of infarct volume across different stroke models (40%-50% reduction), demonstrating the effectiveness of our harmonized protocols and training. Additionally, the implementation of the Neuroscore system across centers showed low variability and consistent results up to 28 days poststroke, underscoring its utility in chronic phase evaluations. CONCLUSIONS: The harmonization of protocols and surgeon training significantly reduced variability in experimental outcomes across different centers. This improvement can increase the comparability of data between research groups and enhance the statistical power of multicenter studies. Our findings also establish the Neuroscore as a reliable tool for long-term assessment in stroke research, paving the way for more consistent and impactful multicenter preclinical studies.

The past, present, and future of the brain imaging data structure (BIDS).

The Brain Imaging Data Structure (BIDS) is a community-driven standard for the organization of data and metadata from a growing range of neuroscience modalities. This paper is meant as a history of how the standard has developed and grown over time. We outline the principles behind the project, the mechanisms by which it has been extended, and some of the challenges being addressed as it evolves. We also discuss the lessons learned through the project, with the aim of enabling researchers in other domains to learn from the success of BIDS.

Relevance of the community pharmacy policy environment to pharmacists' performance, as reflected in stakeholders' perspectives on professionalism and standards.

Background: A complex array of legislation, regulation, policies and aspirational statements by governments, statutory agencies and pharmacy organisations constitutes the policy environment that influences Australian community pharmacy, including pharmacists' performance. Objective: The objective was to assess the relevance of the policy environment to Australian community pharmacists' performance by examining stakeholders' perspectives on their professionalism and standards. Methods: Inductive thematic analysis was undertaken on 38 semi-structured interviews of purposively selected individuals including pharmacists and other key stakeholders, from 4 socio-ecological strata (societal, community, organisational, and individual) that have influence on the person to person interaction that a consumer may have with a pharmacist in a community pharmacy. Results: As indicators of their performance, pharmacists' professionalism and compliance with standards can no longer be assumed; they must be demonstrated. However, the current dispensing funding model compromises their ability to demonstrate professionalism and policy is lacking in relation to monitoring and rewarding standards. These shortcomings are further compromised by a growth in commercialism in community pharmacy which impacts the delivery of professional services. Conclusion: The findings of this study have implications for pharmacy as an autonomously regulated profession in Australia. Dispensing funding policy could better support and reward quality in pharmacists' performance, and there is strong support for compulsory monitoring of standards. Compliance with a nation-wide quality framework, and provision of a minimum set of professional services should be an obligatory requirement of all community pharmacies.